Halting hemorrhage with self-propelling particles and local drug delivery.
Halting hemorrhage with self-propelling particles and local drug delivery.
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DOI：
10.1016/s0049-3848(16)30362-0
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发表时间：
2016-05
影响因子：
7.5
通讯作者：
Kastrup CJ
中科院分区：
文献类型：
--
作者：
Baylis JR;Chan KY;Kastrup CJ
目前正在开发将药物局部输送到身体特定区域的方法，用于许多临床应用，包括治疗出血。可以通过将治疗性凝血剂直接应用于损伤处（例如使用导管或外部输送装置）或通过系统地施用针对血管损伤的分子信号的治疗剂来增加凝块形成和生长区域的治疗性凝血剂的浓度。通过外部措施治疗严重出血具有挑战性，因为血流会将止血剂向外推，从而降低其功效。这篇综述解释说，自推进颗粒可用于在出血期间将治疗药物（例如凝血因子、小分子或其他化学或生物制剂）输送到伤口深处。重点介绍了最近的一个自推进颗粒的例子，其中推进增强了凝血酶和氨甲环酸制剂在治疗两种鼠类出血模型和一种致命的、不可压缩性出血的猪模型中的出血功效。存在许多调节凝血的药物，而促进它们安全输送到血管损伤部位的新方法可以减少全球范围内因出血造成的大量死亡。
Approaches to locally deliver drugs to specific regions of the body are being developed for many clinical applications, including treating hemorrhage. Increasing the concentration of therapeutic coagulants in areas where clots are forming and growing can be achieved by applying them directly to the injury, such as with catheters or external delivery devices, or by systemically administering therapeutics that target molecular signals of vascular damage. Treating severe hemorrhage by external measures is challenging because blood flow pushes hemostatic agents outward, reducing their efficacy. This review explains that self-propelling particles may be used for delivering therapeutics, such as coagulation factors, small molecules, or other chemical or biological agents, deep into wounds during hemorrhage. A recent example of self-propelling particles is highlighted, where propulsion enhanced the efficacy of a formulation of thrombin and tranexamic acid in treating bleeding in two murine models of hemorrhage and a porcine model of fatal, non-compressible hemorrhage. Many agents exist which modulate clotting, and novel approaches that facilitate their safe delivery to sites of vascular injury could reduce the enormous number of deaths from hemorrhage that occur globally.